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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000005

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas SebastionO'Brien Sex Male

Date of Birth April 10, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Elizabeth Goldsmith

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race White Name and present address of Physician in attendance at birth

Signature of Applicant Michael James O'Brien Address of Applicant 260 Quinpool Rd. Halifax Date 8 January 1947

Relationship of Applicant to child Father - Parent

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas SebastionO'Brien

Born at Halifax in the County of Halifax

That Douglas SebastionO'Brien Whose Birth is sought to be registered was

born at Halifax Halifax County on April 10, 1920

My knowledge of the fact and date of such Birth is based on the following Circumstances:

From information given me and ? of the Home of the Guardian Angel, Brunswick Street, Halifax, from where the child was ? This child was born Douglas Goldsmith and subsequently christened at St. Patrick's Church, Halifax as Douglas Sebastian O'Brien - Michael James O'Brien & Mary Danielle O'Brien and the Godparents of their child

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